Background: human immunodeficiency virus (HIV) infection is associated with premature and accelerated aging linked to the development of several co-morbidities, such as cardiovascular events, even after controlling for traditional cardiovascular risk factors. Since both traditional and “novel” factors are involved in the increased cardiovascular risk (CVR) observed in HIV-infected patients, new biomarkers could be needed to diagnose, evaluate and prevent the evolution of these events. Furthermore, since microbiota disturbance is involved in HIV-associated co-morbidities, all strategies focused on reversing or modulating gut microbiota (GM) composition and/or functionality could be of interest. In this context, a solid scientific evidence based on well-designed clinical trials is needed to support the use of prebiotics, probiotics, symbiotics and fecal transplantation (FT) to modify GM in HIV-infected patients and, therefore, to reduce the incidence of cardiovascular disease (CVD) in this population. Methods: a search in PubMed has been carried out covering all clinical trials (Clinical Trial filter) including adult humans (19+ years) and whose results have been published in the last 10 years. Besides, the results obtained from ClinicalTrials.gob have been included and described in the present review Thus, we have reviewed the main results obtained from 3 clinical trials concerning the effects of prebiotics, 25 concerning probiotics, 6 concerning symbiotics and 4 concerning FT. Results: none of the trials included in this review investigated if these compounds were able to reduce cardiovascular events in HIV patients. Conclusions: the huge variability observed in the type of compound used, the dose and the length of administration, makes difficult to analyse the results as a proper meta-3 analysis and, therefore, to adopt general recommendations. Thus, there is an urgent need to investigate in this direction through robust and well-designed clinical trials.